Mots-clés

Panic disorder

Anxiety / Panic attack / Spasmophilia / Panic disorder

Anxiety is an oppressive state of ill-being that has multiple consequences in daily life. For the sufferer, anxiety has no object, appearing inexplicable, with no obvious cause. The unease creates a fear that it will happen again. We can distinguish two types of anxiety: panic attack, during which many repetitions can create a pathological state (see panic disorder) and permanent anxiety which is strongly disabling for the sufferer. Anxiety is often the combination of a psychic state characterised by anxiety and physical changes such as tremors, sweating, cramps, inabaility to breath... An isolated anxiety attack is not pathological, but it can be the marker of an exisiting problem or even the symptom of a psychiatric disorder.
A panic attack or spasmophilia is a response to a feeling of loss of control that appears suddenly and for no particular reason. The victim's heart rate is very fast, which the sufferer may think is a heart attack, they may be short of air, show excessive sweating, shaking, may feel dizzy or convinced they are about to die. It is basically a fight or flight reaction in a non-dangerous situation. It may last up to two hours after which great fatigue and/or relief will set in. When it happens, the person needs to retreat from the place where the panic attack occurred to get to safety. Panic attacks are often a reason for emergency hospital visits because the person is often convinced that they have a serious physical problem, such as a heart attack. The crisis may occur after a period marked by increased stress, even after several months when stress seems non-existent. Drug-taking can also trigger a panic attack, just as an anxiogenic environment can generate seizures. If the panic attack is not pathological in itself, its repetition and the resulting behavioural changes constitute the panic disorder.
Panic disorder is defined as the repetition, more or less frequent, of panic attacks. The diagnosis of panic disorder can only be made if panic attacks are the cause, for at least one month, of a persistent fear of a new attack, concerns about the risks associated with these attacks (fear of dying, going mad, etc.), or more generally of a change in behaviour in particular characterised by avoidance. The basic symptom that is described is anticipatory anxiety, often summarised by the expression "fear of being afraid". The patients affected do not fear a particular situation, but rather their own reactions of fear and this extreme form that represents the panic attack. The main complications of panic disorder, in addition to the daily suffering and functional handicap they can cause (avoidance of places or means of transport, need for permanent support), are depressive episodes, medication and alcohol abuse. These products are initially used for anxiolytic and/or antidepressant purposes, but quickly lead to dependence (alcohol, benzodiazepines) and the disorders worsen concomitantly. Suicidal risks are significant, especially in cases of depressive complications or associated alcoholism.